Psychometric properties of the ORTO-R in a community-based sample of women and men from Poland

Development and validation of the Lebanese Orthorexia Nervosa Inventory (LONI)

BACKGROUND

Unlike eating disorders (ED) that are officially recognized and focusing on the quantity of food, Orthorexia Nervosa (ON) revolves around an unhealthy fixation on the quality of food eaten. Existing ON scales differ in how these conceptualize and define ON, ensuing inconsistency in assessments that not only affects the validity and reliability of ON related research, but also impacts the ability of healthcare professionals to identify and provide support for individuals struggling with ON.

OBJECTIVE

Create the first Eastern locally validated tool that considers the cultural nuances and specificity of the Lebanese general population's eating attitudes and their social context, addresses the limitations of existing scales and thereby provides a valid instrument that can be used in Lebanon and culturally-similar countries.

METHODS

Data were collected between September 2023 and February 2024, enrolling 320 participants for the exploratory factor analysis and 658 for the confirmatory analysis.

RESULTS

Starting from an initial pool of 25 items, the exploratory-confirmatory (EFA-CFA) factor analyses retained 13 items. The LONI showed a unidimensional factor structure, and satisfactory convergent and concurrent validity with a composite reliability (ω and α) of 0.90 providing clear evidence of its high reliability, supporting the stability and consistency of LONI scores across different subsamples. The structural characteristics, factor loadings, and item intercepts of the LONI remained consistent regardless of gender, affirming the tool's stability and reliability in measuring ON traits across diverse populations.

CONCLUSION

The LONI is a valid tool for assessing ON, particularly in accounting for Lebanese and culturally similar populations. The scale's unidimensional structure allows for straightforward calculation of the score, making it practical for both clinical and research applications, while offering a unique advantage in considering regional dietary patterns compared with existing ON screening tools due to its cultural specificity and psychometric strengths. The ON prevalence was high in the present sample, underscoring the significance of sociocultural and behavioral factors in its manifestation.

Intra- and Interpersonal Dimensions of Orthorexia: Preliminary Development and Validation of an Intra- and Interpersonal Effects Scale for Orthorexia

Orthorexia nervosa (ON) is a disorder characterized by dietary restrictions and an obsessive focus on "healthy" eating. The present study analyzes two aspects of ON. One related to the inner experiences of the individual (intrapersonal). The other concerns the impact of ON on interpersonal relationships (interpersonal). The developed scale was named the Intra- and Interpersonal Effects Scale of Orthorexia (IIESO). The analysis showed an average correlation between the INTER and INTRA factors (r = 0.46). Both the INTER and INTRA scales correlated strongly with both subscales of the TOS but weakly with the ORTO-R score. Females obtained higher scores on the INTER scale (p < 0.01), while no differences were shown for the INTRA subscale or the overall scale score (p < 0.01). Subjects using supplements had higher mean scores on the INTER and INTRA subscales and for the total score. Among the analyzed results, the greatest strength effect was shown for the total score on the IIESO scale (INTER+INTRA) and the TOS scale. The questionnaires used to date have not distinguished between behaviors from interpersonal and intrapersonal perspectives. Research on these dimensions could expand our knowledge of the disorder and refine diagnostic criteria.

Measuring Pathological and Nonpathological Orthorexic Behavior: Validation of the Teruel Orthorexia Scale (TOS) among Polish Adults

Measuring orthorexia nervosa is challenging due to the use of various existing tools and problems with sample representativeness. Another challenge for the Polish population is the adaptation of existing research tools and the evaluation of their relevance and research reliability. Our research aimed to adapt the TOS to the Polish language and measure pathological and nonpathological orthorexic behavior among the Polish population. The adaptation of the PL-TOS has high psychometric value and allows us to assess healthy and nervous orthorexia levels. This scale can be used not only for further research but also for diagnostic purposes in the daily work of clinicians and psychologists. Our results obtained in the present study indicate a correlation between TOS and both the use of supplements and diet. Higher TOS, ORTO_R and KZZJ_Diet Restrictions scores were obtained for individuals using dietary supplements than for those not using dietary supplements. In the future, it is worth conducting research aimed at various risk groups of individuals with orthorexia to confirm the psychometric properties of this adaptation of the TOS.